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General NPI Number Information
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NPI Number | 1689170169
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Entity Type | Individual
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Provider Name | MARTIN JOHN AHERN MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1600 W 24TH ST
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City | PUEBLO
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State | CO
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Zip | 81003-1411
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Country | US
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Telephone | 719-546-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1108
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City | SALIDA
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State | CO
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Zip | 81201-1108
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Country | US
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Telephone | 603-370-7977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | DR0068400
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR0068400
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License Number State | CO
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